Provider Demographics
NPI:1609682921
Name:ARZUMANYAN, SERGEY
Entity type:Individual
Prefix:
First Name:SERGEY
Middle Name:
Last Name:ARZUMANYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 N STATE COLLEGE BLVD APT 1035
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-5704
Mailing Address - Country:US
Mailing Address - Phone:818-854-5680
Mailing Address - Fax:
Practice Address - Street 1:480 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3836
Practice Address - Country:US
Practice Address - Phone:714-938-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist